Health outcomes and economic consequences of using angiotensin-converting enzyme inhibitors in comparison with angiotensin receptor blockers in the treatment of arterial hypertension in the contemporary Polish setting

2016 ◽  
pp. 1016-1024
Author(s):  
Witold Wrona ◽  
Katarzyna Budka ◽  
Krzysztof J. Filipiak ◽  
Maciej Niewada ◽  
Bogdan Wojtyniak ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Economic Consequences ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

scholarly journals Comparative analysis of the angiotensin receptors blockers and angiotensin-converting enzyme inhibitors in the treatment of arterial hypertension (review of literature)

2020 ◽  
Vol 43 (4) ◽  
pp. 490-497
Author(s):  
Mariya S. Matveenko ◽  
◽  
Keyword(s):  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Cardiovascular diseases are still one of the main causes of death and disability among the adult population, the search for optimal pharmacotherapy of arterial hypertension remains an urgent task. The renin-angiotensin-aldosterone system (RAAS) plays a direct role in the pathophysiology of arterial hypertension, being responsible for regulating fluid volume and maintaining water - salt balance. RAAS is also responsible for the processes of tissue growth and differentiation, apoptosis, and affects the synthesis of many neurohumoral factors. By increasing the activity of the RAAS angiotensin II contributes to vasoconstriction, increased secretion of aldosterone and the activity of the sympathetic nervous system, which in turn leads to the development and progression of hypertension. Angiotensin–II receptor blockers (ARBs) block the AT1 subtype receptors of the same name, which is accompanied by vasodilation, a decrease in the secretion of vasopressin and aldosterone. RAAS blockade is an effective modern reliable way to control blood pressure, as well as prevent related complications. angiotensin converting enzyme inhibitors and angiotensin receptor blockers have similar hypotensive effects and a high safety profile. Due to differences in the mechanism of action, when taking angiotensin receptor blockers, the frequency of undesirable side effects is recorded less, and, accordingly, adherence to treatment is greater. One of the modern angiotensin receptor blockers, olmesartan in various studies has demonstrated its superiority over angiotensin-converting enzyme inhibitors (ramipril and perindopril) in the treatment of arterial hypertension. Olmesartan has proven itself both in monotherapy and in combination with a dihydropyridine calcium channel blocker or a thiazide diuretic.

scholarly journals Análise da Revisão Cochrane: Inibidores da Enzima de Conversão da Angiotensina Versus Antagonistas do Receptor da Angiotensina como Prevenção Cardiovascular na Hipertensão Essencial. Cochrane Database Syst Rev. 2014,8: CD009096.

2015 ◽  
Vol 28 (3) ◽  
pp. 283 ◽  
Author(s):  
Luís Nogueira-Silva ◽  
João A. Fonseca
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Cardiovascular Events ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Total Mortality ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Angiotensin converting enzyme inhibitors and angiotensin receptor blockers are first line drugs in the treatment of hypertension. The aim of this review was to assess if there are differences between these drug classes regarding the prevention of total mortality, occurrence of cardiovascular events and of adverse effects. A systematic review and metanalysis was performed, searching for studies that compare angiotensin converting enzyme inhibitors and angiotensin receptor blockers face-to-face, in several databases until July 2014. The study selection and data extraction were performed by 2 independent researchers. Nine studies were included, with a total of 10 963 participants, 9 398 of which participated in the same study and had high cardiovascular risk. No differences were observed regarding total mortality, cardiovascular mortality or total cardiovascular events. A slightly smaller risk was observed with angiotensin receptor blockers regarding withdrawal due to adverse effects (55 people were needed to be treated with angiotensin receptor blockers for 4.1 years to avoid one withdrawal due to adverse effect), mainly due to the occurrence of dry cough with angiotensin converting enzyme inhibitors. Thus, no differences were observed between angiotensin converting enzyme inhibitors and angiotensin receptor blockers in the prevention of total mortality and cardiovascular events, and angiotensin receptor blockers were better tolerated. Given the large proportion of participants with a high cardiovascular risk, the generalization of these results to other populations is limited.

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